Changes to the 2021/22 GMS contract for GPs

Changes to the 2021/22 GMS contract for GPs

Thursday, 15 April 2021

Details of the GMS contract for 2021/22 for England have recently been announced.

The main financial headlines are:

  • The global sum is increased by £3.32 per weighted patient, up from £93.46 to £96.78 (an increase of 3.55%).
  • The out of hours opt-out cost will increase by 14p to £4.59.
  • The value of each Quality and Outcomes Framework (QOF) point will increase to £201.16, an uplift of £6.33 or 3.3%. QOF will be based on the indicators set from 2020/21, with some limited changes (see below regarding vaccinations and immunisations).
  • Therefore, for a GP practice with a normalised weighted list size of 9,000 patients, global sum funding will increase by £28,620 per annum.

The above is designed to allow for a 2.1% pay and expenses increase at a time when there will be a wider public sector pay restraint/freezes. NHS England is undertaking a data collection survey to get an accurate baseline of current terms and conditions of practice staff to inform the development of good practice guidance on employment terms and conditions. We expect the results to be publicised in the coming months.

Other changes to GP contracts are:

  • The cervical screening additional service becomes an essential service.
    As agreed last year, the childhood immunisation targets Directed Enhanced Services (DES) will cease, to be replaced by a vaccinations and immunisations domain in the QOF worth 64 points, which will be funded by monies recycled from the DES. Practices will be paid £10.06 for each vaccination, with clawbacks for those practices which do not vaccinate 80% of eligible patients. The details of the clawback procedure have not yet been published but, based on announcements made last year by the GPC (general practitioners committee), we believe that:
  1. Practices achieving less than 80% of their target cohort will not receive payment for the first 50% of their cohort but will receive an Items of Service (IOS) payment for each immunisation administered above the 50%.
  2. Those achieving over 80% of their target cohort will receive the IOS for each immunisation administered.
  3. In limited circumstances, practices may be able to retain the full payment when coverage remains low due to patient or practice list demographics.
  4. The 70%/90% ‘cliff-edge’ targets will be removed from 2021/22.
  5. Practices will receive a monthly ‘aspiration payment’ in a similar vein to QOF, based on previous achievement, which will be reconciled at the year end.
  • There will be additional funding invested into the QOF for health checks on patients with serious mental illness.
    Support for the funding of the additional work caused by COVID-19 is ongoing and being kept under review.
  • There is definition of the ‘core digital offer’ practices must provide, including the ability to hold video consultations, together with the ability for online appointment booking and online prescription requests.
  • There are also plans to introduce a new enhanced service to deal with obesity, but the details of this are not yet agreed.
  • NHS England is also to look at practice staff terms and conditions with a view to making information regarding gender practice pay gap information more available. This may lead to a reduction in staff morale and pressure to increase staff salaries, with a resulting impact on practice profitability.
  • There will be a more phased approach to the introduction of new Impact & Investment Fund indicators for 2021/22. We expect this to be reviewed as the impact of the pandemic eases.
  • Primary Care Networks will see previously agreed changes to the Additional Roles Reimbursement Scheme to allow for the employment of paramedics, advanced practitioners and mental health practitioners. The mental health practitioners will be employed through collaboration with the Primary Care Network’s community mental health services provider. Limits will be removed on the number of pharmacy technicians and physiotherapists that can be reimbursed.
  • Extended Access Services have been used to support the general practice pandemic response, including the delivery of the COVID-19 vaccination programme. The transfer of funding for the Clinical Commissioning Groups (CCG) commissioned Extended Access Service will now take place in April 2022, with a nationally consistent service specification being developed by summer 2021.

For more information about GMS contract changes or any other GP practice or tax issue, please get in touch with your usual contact. You can find contact details on the Our People section of our website. Alternatively, call 0330 024 0888 or email

Melanie Garrett





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